局部麻醉剂在怀孕期间的系统性毒性:回顾性队列分析
Micah K De Valle1, Michael Adkison1, Ruhi Maredia1
1John Sealy School of Medicine, University of Texas Medical Branch, Galveston, USA.
与非孕妇相比,患有局部麻醉系统毒性 (LAST) 的孕妇表现出明显的症状,心脏抑郁的风险更高,刺激或前兆效应的迹象较少.
科学领域:
- 麻醉学 麻醉学
- 产科 产科 产科 产科 产科
- 药理学 药理学是指药理学的学科.
背景情况:
- 局部麻醉系统毒性 (LAST) 是局部麻醉的一个罕见但严重的并发症.
- 怀孕相关的生理变化可能会改变LAST的表现和识别.
- 妊娠障碍可能会掩盖或延迟LAST症状,使及时干预复杂化.
研究的目的:
- 为了比较LAST在孕妇和非孕妇患者的临床特征.
- 确定特定的指标来区分这两个群体之间的LAST表现.
- 了解怀孕如何影响LAST的表现.
主要方法:
- 利用TrinetX数据库识别和比较2013年至2023年期间被诊断患有LAST的孕妇和非孕妇患者.
- 根据年龄,种族,肥胖,糖尿病,新陈代谢,心血管,肝脏,脏和呼吸系统的情况匹配的队列.
- 分析并比较了前兆症状的发生率,以及中枢神经系统 (CNS) 和心脏刺激和抑郁.
主要成果:
- 匹配的队列包括276名孕妇和276名非孕妇患者.
- 孕妇患者表现出显著更高的心脏抑郁风险 (RR=1.96) 和更低的心脏刺激风险 (RR=0.38).
- 孕妇队列显示出明显降低了前兆症状 (RR=0.17),中枢神经系统刺激 (RR=0.44),中枢神经系统抑郁 (RR=0.24) 的风险.
结论:
- 患有LAST的孕妇更容易患心脏抑郁症,不太可能表现出前兆或中枢神经系统刺激症状.
- 怀孕相关的生理变化可能会解释LAST的不同临床表现.
- 识别这些独特的特征对于迅速诊断和有效管理孕妇LAST至关重要.
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